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Recovery time for broken collarbone surgery: Broken collarbone recovery time | TRIA blog

Collarbone surgery: Procedure, uses, and recovery

Collarbone surgery involves repairing a broken clavicle bone. Surgeons will try to realign the displaced bone and fix it in place to help it heal. People can usually return to their usual activities within 3 months.

The clavicle, or collarbone, sits on top of the rib cage in front of the chest. It provides support for shoulder movement.

A collarbone fracture often occurs due to a fall onto the shoulder or an outstretched arm. This type of fracture is common. About 5% of all adult fractures involve the collarbone. About 35%-45% of breaks in the shoulder area involve the collarbone.

After a collarbone fracture, doctors may recommend surgery. This article explores collarbone surgery, including what happens during the procedure, risks, and recovery.

Share on PinterestJessica Christian/The San Francisco Chronicle via Getty Images

Doctors may treat a collarbone fracture with or without surgery. In some cases, conservative treatment without surgery is an option. But in other instances, doctors recommend surgery.

The break can occur in the following places:

  • In the middle of the collarbone, where the bone attaches to the shoulder blade or ribcage. This is the most common type of clavicle fracture.
  • Near the acromioclavicular (AC) joint, where the clavicle meets the shoulder. This is the second most common type of fracture.
  • Close to the sternum (breastbone). This is the least common type of break.

The need for collarbone surgery depends on the severity of the fracture. Sometimes, the bone may only crack. However, more serious fractures can result in the collarbone breaking into several pieces.

Collarbone surgery involves putting the bone back into the correct alignment, which promotes proper healing.

Doctors may recommend collarbone surgery in the following situations:

  • A displaced fracture: This involves a break that moves the bone so much that it becomes misaligned. This fracture has an increased chance of complications, such as not healing well.
  • An open fracture: This refers to a broken bone that breaks through the skin. An open fracture causes an increased risk of problems, such as infection.
  • A non-healing fracture: Collarbone fractures may also involve nonsurgical treatments. However, about 30% of collarbone fractures treated without surgery do not heal properly. When a nonsurgical approach fails, surgery may become an option.

Learn more about the causes of collarbone pain.

Collarbone surgery aims to stabilize the broken bone, allowing it to heal in the correct position.

Surgery usually involves open reduction and internal fixation (ORIF) surgery. This is where surgeons realign the misplaced bones and then fix them in place with screws, pins, plates, or rods.

Typically, doctors perform the surgery under general anesthesia, which means a person is unconscious throughout the procedure.

ORIF surgery involves the surgeon:

  1. applying antiseptic to the skin area, which helps prevent infection
  2. making an incision in the skin and muscle near the collarbone
  3. aligning and repositioning the pieces of bone
  4. inserting plates, screws, or pins to hold the bones in place and improve shoulder strength

Learn more about bone fracture repair.

Anyone having surgery on their clavicle will receive specific instructions before the operation. This may include stopping certain medications for a time before surgery. However, a person should not stop taking medications until a healthcare professional has instructed them to do so.

Preparation may also include getting an X-ray of the collarbone to determine the severity of the bone misalignment.

Usually, before surgery, doctors order blood tests and an EKG to check for any abnormalities that may prevent the surgeon from operating safely.

Healing time after collarbone surgery can vary depending on someone’s overall health and lifestyle. For example, smoking tobacco may slow the healing process. Most people can resume regular activities about 3 months after the surgery.

During initial recovery, a person will wear a sling to keep the shoulder from moving. Pain levels may vary. But some pain is a natural part of the healing process. The doctor will advise how to manage pain during recovery.

A small patch of skin below the cut may feel numb. This may become less noticeable over time. Some people report feeling the plate that holds the bones in place.

A healthcare professional may also recommend physical therapy after an initial period of healing. Physical therapists can aid recovery by teaching people exercises to improve their range of motion and strengthen the shoulder.

Regular follow-up appointments with a healthcare professional are necessary to ensure the bone heals well.

Learn more about how broken bones heal.

The outcome of collarbone surgery is typically good. But it is not clear whether surgery leads to better overall healing.

This 2018 research involved a small study of 138 people with closed midshaft collarbone fractures. Of the participants, 69 had collarbone surgery, and 69 received nonoperative treatment.

The study found no differences in poor outcomes or complications between the group treated with surgery and the nonsurgical treatment group.

But other research has found that surgery provides a more favorable recovery than nonsurgical treatment. A 2022 systematic review and meta-analysis involved 3,094 people with a closed midshaft collarbone fracture. The study indicated that surgical treatment led to fewer complications and better long-term function than nonsurgical treatment.

Doctors might recommend nonsurgical treatment for a collarbone fracture if the bones are not significantly misaligned.

Treatment may include:

  • wearing a sling to prevent the bone from moving while healing
  • icing the area to reduce inflammation
  • taking pain medication, such as acetaminophen (Tylenol), to relieve pain as the bone heals
  • doing physical therapy to improve strength and range of motion

Learn more about how fractures heal here.

All surgery carries risks, including the risk of infection and excessive bleeding. Sometimes, the bone does not heal properly after collarbone surgery, which is known as non-union. However, the overall infection and non-union rate for collarbone surgery affect fewer than 4.5% of people.

A large number of nerves surround the collarbone. Nerve injury due to the surgery can occur but is uncommon.

Another possible risk involves discomfort from the pins, screws, or plates used to hold the bone in place.

Collarbone surgery involves the repair of a clavicle fracture. Not all collarbone fractures require surgery. But for an open or displaced fracture, healthcare professionals often recommend surgery.

Surgery involves putting the bone into the proper position and fixing it using pins, rods, screws, or plates to keep it in place.

Healing times vary, but people typically resume their usual activities within 3 months.

Collarbone surgery: Procedure, uses, and recovery

Collarbone surgery involves repairing a broken clavicle bone. Surgeons will try to realign the displaced bone and fix it in place to help it heal. People can usually return to their usual activities within 3 months.

The clavicle, or collarbone, sits on top of the rib cage in front of the chest. It provides support for shoulder movement.

A collarbone fracture often occurs due to a fall onto the shoulder or an outstretched arm. This type of fracture is common. About 5% of all adult fractures involve the collarbone. About 35%-45% of breaks in the shoulder area involve the collarbone.

After a collarbone fracture, doctors may recommend surgery. This article explores collarbone surgery, including what happens during the procedure, risks, and recovery.

Share on PinterestJessica Christian/The San Francisco Chronicle via Getty Images

Doctors may treat a collarbone fracture with or without surgery. In some cases, conservative treatment without surgery is an option. But in other instances, doctors recommend surgery.

The break can occur in the following places:

  • In the middle of the collarbone, where the bone attaches to the shoulder blade or ribcage. This is the most common type of clavicle fracture.
  • Near the acromioclavicular (AC) joint, where the clavicle meets the shoulder. This is the second most common type of fracture.
  • Close to the sternum (breastbone). This is the least common type of break.

The need for collarbone surgery depends on the severity of the fracture. Sometimes, the bone may only crack. However, more serious fractures can result in the collarbone breaking into several pieces.

Collarbone surgery involves putting the bone back into the correct alignment, which promotes proper healing.

Doctors may recommend collarbone surgery in the following situations:

  • A displaced fracture: This involves a break that moves the bone so much that it becomes misaligned. This fracture has an increased chance of complications, such as not healing well.
  • An open fracture: This refers to a broken bone that breaks through the skin. An open fracture causes an increased risk of problems, such as infection.
  • A non-healing fracture: Collarbone fractures may also involve nonsurgical treatments. However, about 30% of collarbone fractures treated without surgery do not heal properly. When a nonsurgical approach fails, surgery may become an option.

Learn more about the causes of collarbone pain.

Collarbone surgery aims to stabilize the broken bone, allowing it to heal in the correct position.

Surgery usually involves open reduction and internal fixation (ORIF) surgery. This is where surgeons realign the misplaced bones and then fix them in place with screws, pins, plates, or rods.

Typically, doctors perform the surgery under general anesthesia, which means a person is unconscious throughout the procedure.

ORIF surgery involves the surgeon:

  1. applying antiseptic to the skin area, which helps prevent infection
  2. making an incision in the skin and muscle near the collarbone
  3. aligning and repositioning the pieces of bone
  4. inserting plates, screws, or pins to hold the bones in place and improve shoulder strength

Learn more about bone fracture repair.

Anyone having surgery on their clavicle will receive specific instructions before the operation. This may include stopping certain medications for a time before surgery. However, a person should not stop taking medications until a healthcare professional has instructed them to do so.

Preparation may also include getting an X-ray of the collarbone to determine the severity of the bone misalignment.

Usually, before surgery, doctors order blood tests and an EKG to check for any abnormalities that may prevent the surgeon from operating safely.

Healing time after collarbone surgery can vary depending on someone’s overall health and lifestyle. For example, smoking tobacco may slow the healing process. Most people can resume regular activities about 3 months after the surgery.

During initial recovery, a person will wear a sling to keep the shoulder from moving. Pain levels may vary. But some pain is a natural part of the healing process. The doctor will advise how to manage pain during recovery.

A small patch of skin below the cut may feel numb. This may become less noticeable over time. Some people report feeling the plate that holds the bones in place.

A healthcare professional may also recommend physical therapy after an initial period of healing. Physical therapists can aid recovery by teaching people exercises to improve their range of motion and strengthen the shoulder.

Regular follow-up appointments with a healthcare professional are necessary to ensure the bone heals well.

Learn more about how broken bones heal.

The outcome of collarbone surgery is typically good. But it is not clear whether surgery leads to better overall healing.

This 2018 research involved a small study of 138 people with closed midshaft collarbone fractures. Of the participants, 69 had collarbone surgery, and 69 received nonoperative treatment.

The study found no differences in poor outcomes or complications between the group treated with surgery and the nonsurgical treatment group.

But other research has found that surgery provides a more favorable recovery than nonsurgical treatment. A 2022 systematic review and meta-analysis involved 3,094 people with a closed midshaft collarbone fracture. The study indicated that surgical treatment led to fewer complications and better long-term function than nonsurgical treatment.

Doctors might recommend nonsurgical treatment for a collarbone fracture if the bones are not significantly misaligned.

Treatment may include:

  • wearing a sling to prevent the bone from moving while healing
  • icing the area to reduce inflammation
  • taking pain medication, such as acetaminophen (Tylenol), to relieve pain as the bone heals
  • doing physical therapy to improve strength and range of motion

Learn more about how fractures heal here.

All surgery carries risks, including the risk of infection and excessive bleeding. Sometimes, the bone does not heal properly after collarbone surgery, which is known as non-union. However, the overall infection and non-union rate for collarbone surgery affect fewer than 4.5% of people.

A large number of nerves surround the collarbone. Nerve injury due to the surgery can occur but is uncommon.

Another possible risk involves discomfort from the pins, screws, or plates used to hold the bone in place.

Collarbone surgery involves the repair of a clavicle fracture. Not all collarbone fractures require surgery. But for an open or displaced fracture, healthcare professionals often recommend surgery.

Surgery involves putting the bone into the proper position and fixing it using pins, rods, screws, or plates to keep it in place.

Healing times vary, but people typically resume their usual activities within 3 months.

Clavicle Fracture – Physiotherapist

Clavicle fractures are very common in adults (2-5%) and children (10-15%) and account for 44-66% of all shoulder girdle fractures. This is the most common fracture among pediatric patients. Most often, a clavicular fracture is caused by a fall on the lateral side of the shoulder. X-rays confirm the diagnosis and help in further examination and treatment. While most clavicle fractures are treated conservatively, severely displaced or comminuted fractures may require surgical fixation [1].

Contents

Clinically relevant anatomy

The clavicle lies under the skin between the sternum and shoulder blade and connects the upper limb to the body. [1]

The clavicle, the first of the bones in the human body, begins to ossify in the connective tissue membrane directly from the mesenchyme as early as the fifth week of fetal life. Like all tubular bones, the clavicle has both a medial and a lateral epiphysis, but lacks a distinct medullary cavity. The epiphyseal plates of the medial and lateral epiphyses of the clavicle do not fuse until the age of 25. The clavicle differs from tubular bones in its characteristic S-shaped double curvature, convex in the medial direction and concave in the lateral direction. This shape allows the clavicle to serve as a support for the upper limb, as well as to protect the axillary vessels and the brachial plexus and ensure their passage from the medial side. [2]

Etiology

Young patients suffer fractures due to moderate or high-energy injuries such as car accidents or sports injuries, while older people suffer from low-energy falls.

Traditionally, the cause of the fracture was considered to be a fall onto an outstretched arm, but it has been found that most often the clavicle is injured as a result of applying a direct compressive force directly to the shoulder. [2] Approximately 87% of clavicle fractures result from a fall directly on the lateral side of the shoulder. [1

Mechanism of injury.

  1. Fall on a straight arm.
  2. Shoulder drop.
  3. Direct blow to the shoulder.

Epidemiology

Clavicle fractures account for 2% to 10% of all fractures. Clavicle fractures [1]

  • Found in 1 in 1000 people per year
  • Are the most common fractures among pediatric patients
  • Approximately two thirds of all clavicle fractures occur in men.
  • There is a bimodal distribution of clavicle fractures, with 2 peaks occurring in men under 25 years of age (sports injuries) and patients over 55 years of age (falls).
  • The middle third of the clavicle breaks in 69% of cases, the distal third in 28%, and the proximal third in 3%. [1]
  • They account for up to 10% of all sports-related fractures and have the third longest return to sport, with up to 20% of athletes with such injuries not returning to sport. [3]

The clavicle is the only bony link between the upper limb and the trunk Due to its superficial subcutaneous location and the numerous ligamentous and muscular forces applied to the clavicle, this bone breaks easily. The middle third of the clavicle is the thinnest area that does not have ligamentous attachments, so its fractures are most likely. [1]

Classification

Clavicle fractures are usually described according to the Allman classification system, which divides fractures into 3 groups based on location. The system was later revised by Nier (Group II was further classified into 3 types). [1

  1. Group I: Fractures in the middle third of the diaphysis (most common),
  2. Group II: Fractures of the distal or lateral third. Frequent site of nonunion.
  3. Group III: Fractures of the proximal or medial third.

The Robinson classification was more specific for different types of fractures in the middle third, while the Craig classification was for fractures of the lateral third. [4]

Clinical History and Physical Examination

The patient has the following symptoms and signs:

  • The patient can hold the injured limb with a healthy hand.
  • Patient may report clicking or popping sound when injured.
  • The shoulder may appear to be shortened relative to the opposite side and lowered.
  • There may be swelling, ecchymosis, and tenderness over the clavicle.
  • An abrasion over the clavicle may be noted, indicating that the fracture occurred by a direct mechanism.
  • With careful manipulation, the sound of crepitus can be noted from the friction of the ends of the fracture against each other.
  • Labored or weak breathing on the affected side may indicate lung injury, such as pneumothorax.
  • Palpation of the scapula and ribs may reveal associated lesions.
  • Stretching and pallor of the skin at the fracture site may indicate an open fracture, which most often requires surgical stabilization.
  • Non-use of the hand of the affected side is a neonatal manifestation.
  • Associated distal nerve dysfunction indicates damage to the brachial plexus.
  • Decreased heart rate may indicate damage to the subclavian artery.
  • Venous congestion, discoloration and swelling indicate subclavian vein damage. [5]

Differential diagnosis

Diagnosis is based on the patient’s history and physical examination.[6]

The differential diagnosis of a clavicle fracture includes acromioclavicular joint injury, rib fractures, scapular fracture, shoulder dislocation, rotator clavicle injury, and sternoclavicular joint injury.

The potential complications of clavicle fractures, including pneumothorax, brachial plexus injury, and subclavian vessel injury, should also be fully assessed. [1]

Depending on the severity of the clavicle fracture, laboratory tests are ordered. If vascular damage is suspected, a general clinical blood test (CBC) should be performed to check hemoglobin and hematocrit values. If lung injury is suspected or detected, an arterial blood gas test and an exhaled posterior-anterior chest x-ray should be performed. Imaging studies are also performed to evaluate a clavicle fracture, such as:

  • Clavicle and shoulder X-ray
  • Computed tomography (CT) with 3-dimensional (3-D) reconstruction
  • Arteriography
  • Ultrasound scanning [5]

Medical treatment

Fracture of the clavicle is treated surgically or conservatively depending on the location (middle, distal, proximal), nature (displaced, non-displaced, comminuted) of the fracture, the presence of open or closed injury, age and neurovascular disorders. [3]

Traditionally, clavicle fractures have been treated conservatively with immobilization with a bandage and subsequent rehabilitation. For non-displaced fractures, such treatment gives satisfactory results, but for fractures of the middle part of the clavicle with displacement, it leads to an increase in the likelihood of re-injury, time to return to sports and the development of suboptimal shoulder function secondary to malunion and shortening of the clavicle with subsequent scapular thoracic dyskinesia. It has also been shown that conservative treatment of lateral displaced fractures in an athlete results in high rates of nonunion and subsequent impairment of shoulder function.

Thus, surgery is performed for lateral fractures with displacement in athletes, and is also recommended for fractures of the middle third of the diaphysis with complete displacement, shortening > 2 cm, or the presence of splinters. [3]

Surgical treatment

The main goal of this treatment is to achieve fusion of the clavicle in a normal anatomical position.

Indications for surgical treatment of clavicle fractures: [7]

  1. Severe displacement caused by crushing followed by angular bending and severe stretching of the skin, threatening its integrity, and in the absence of a response to closed reduction.
  2. Symptomatic nonunion such as shoulder girdle dysfunction, neurovascular disorders.
  3. Neurovascular injury or impairment that progresses or does not recover after closed fracture reduction.
  4. Open fracture.
  5. Type II distal clavicle fracture (displaced).
  6. Multiple injuries where mobilization is desired and closed methods of immobilization are not practical or possible.
  7. “Floating shoulder”
  8. Inability to tolerate closed immobilization, eg neurological problems of parkinsonism, convulsive disorders.
  9. Aesthetic reasons
  10. Relative readings include shortening of more than 15-20 mm and displacement of more than the width of the clavicle.

Surgical procedures include:[8]

  • Internal fixation with plates and screws. (most common)
  • Intramedullary (IM) fixation.

For displaced fractures of the middle shaft, removal of metal structures is recommended if intramedullary nails are used, but not fixation plates. While in case of a lateral fracture of the clavicle with a displacement, the removal of metal structures was carried out with fixation with a hook-shaped plate, rods, cerclage and tie wire, but not with fixation with plates that did not capture the ACJ, and with a suture. These methods of fixation are necessary for a lateral fracture of the clavicle, as they capture the acromioclavicular joint and various ligaments that can be damaged during a fracture. [3]

Physical Therapy / Rehabilitation

The main goal of rehabilitation is to improve and restore the function of the shoulder for everyday, professional and sports activities. The rehabilitation protocol may differ slightly in the first few weeks depending on the main approach to treatment, i. e. conservative or surgical.

Rehabilitation after conservative treatment

Non-operative treatment may take longer for fractures to heal. With conservative treatment, midshaft clavicle fractures usually heal between 18 and 28 weeks after injury. Therefore, it is necessary to regularly check whether the fracture site heals correctly or not. Thus, the rehabilitation protocol may also vary depending on individual comorbidities.

In the first few weeks (2-4 weeks) of an acute clavicle fracture, the POLICE principle can be used, which is explained below in the context of a clavicle fracture.

Protection

The patient’s shoulder is immobilized in a bandage or 8-band until clinical union is achieved. It is believed that the 8-bandage prevents or reduces the secondary shortening of the fracture during its healing. But it is associated with great discomfort and pain, including nerve compression with temporary paralysis of the brachial plexus and obstruction of venous blood return. [9]]Studies have shown that in the treatment of clavicle fractures, there is no difference between the two methods in terms of healing time and percentage of nonunions. Thus, a brace is commonly used, and immobilization in internal rotation for 2-4 weeks is recommended.[9] [1] The bandage is worn during the day, except for exercise and personal hygiene. The patient independently decides to leave it at night or not, but care should be taken. [9]

During severe coughs and sneezes, patients should also be careful (since respiratory excursions can cause collarbone movement) to avoid them as much as possible, and to learn active-passive coughing techniques.

Optimal loading

Therapy/Consultation within 1-2 weeks after injury:

  • Use of a shoulder brace as mentioned above (must be worn most of the time).
  • Self-mobilization is required to avoid stiffness of the elbow and wrist joints several times a day.
  • Raising the elbow above shoulder height may be painful.
  • During the first 1-2 weeks, the development of the range of motion of the shoulder is limited to pendulum exercises.
  • Teaching correct neck position and range of motion.

Therapy/Counseling 3 to 6 weeks after injury:

  • Decreased bandage wear time (use in independent position).
  • Return to light daily activities using the arm and shoulder.
  • During the first 6 weeks, active-passive movements in the shoulder joint are recommended with an amplitude of active movements in one plane with a deviation of no more than 90 degrees.
  • Scapular mobilization exercises are included.
  • Isometric Shoulder Exercise with Tolerable Resistance Starting at 4-6 weeks
  • Heavy exercise should be avoided for a full 6 weeks.
  • A gradual increase in the intensity of cardiovascular endurance training can begin with a brisk walk and a stationary bike.

Therapy/Consultation between 6 and 12 weeks after injury:

  • As a rule, after 6 weeks with tolerable passive BP, active and active-passive range of motion of the shoulder in all planes is allowed.
  • Progressive resistance exercises (isotonic) for the stabilizing muscles of the scapula, biceps, triceps, and rotators are given after 6 weeks.
  • Arm stress should be avoided until clinical healing of the fracture.
  • Sports and activities that require arm loading and use are usually suspended until pain subsides and radiological signs of progressive fracture consolidation are obtained, usually after 6 to 12 weeks.

Therapy/Counseling after 12 weeks or more:

Start a more intense strengthening program, cardiovascular endurance training as tolerated, and progressive athletic training.

  • The period of return to specific sports is determined by the physiotherapist using functional tests based on the needs of the patient, according to which a specific progressive sports training is planned.[12]
  • Preliminary activities such as muscular endurance exercises (upper body ergometer) and cardiovascular endurance exercises (treadmill, cycling) may be prescribed.
  • Contact sports should be avoided for 3-4 months. Returning to full contact sports requires that the athlete demonstrate radiological evidence of bone healing, no tenderness to palpation, full range of motion, and normal shoulder muscle strength [9][1].

Rehabilitation after surgery

  • For fractures of the middle third of the clavicle, the initial open reduction with internal fixation with a plate (fixation compression plate) and screws provides more stable fixation and immediate postoperative mobilization. [7] With surgical treatment, fractures heal faster than with conservative treatment. Thus, the duration of immobilization is shorter compared to conservative treatment, and mobilization and strengthening exercises can be prescribed earlier. A program similar to conservative treatment to increase the intensity of exercise can be prescribed, but much earlier.

Return to sports

According to a systematic review by Robertson and Wood in 2016, most patients with acute clavicle fractures return to sports, with about four-fifths of all patients able to return to their pre-injury level of sports activity. [3]

Studies have shown that the period to return to sport is from 6 to 12 weeks with surgery and 3-4 months with conservative treatment. [3] [1]

Conservative treatment of displaced midshaft fractures has been shown to reduce the percentage and increase the time to return to sport compared with surgery. Conservative treatment of displaced midshaft fractures can lead to re-fracture (more than half of cases) and delayed surgery (more than a quarter of cases). In terms of surgical technique recommendations for midshaft fractures, both plate fixation and intramedullary screws demonstrated nearly 100% recovery and similar recovery times. [3]

For lateral displaced clavicle fracture, surgical management is standardized and shows an increase in percentage and a reduction in return time. Non-ACC plate fixation and suture fixation provide better outcomes for athletes than other methods of fixation, which is likely due to preservation of ACC function. A lateral fracture of the clavicle is more difficult than a fracture of the middle shaft, so the outcome of the latter is better. [3]

Conclusion

  • Patients with collarbone fractures are best referred to an interprofessional team that includes an orthopedic surgeon, an emergency room physician, a general practitioner, a nurse practitioner, and a physical therapist.
  • Immediate orthopedic consultation should be performed for patients with neurovascular disease, open fractures, skin stretch, or any skin tear near the fracture.
  • For non-displaced fractures, non-surgical treatment is the first choice.
  • While surgical treatment is generally accepted for lateral displaced fractures in athletes and is recommended for midshaft displaced fractures. Surgical treatment results in improved percentage and time of return compared to conservative treatment. [3]
  • Fracture healing may take 8-12 weeks with a good outcome for most patients. However, some patients may experience chronic pain and limited range of motion of the shoulder joint. [1]
  • In acute cases and cases of postoperative nonunion, an early mobilization rehabilitation protocol may be recommended [11].

rehabilitation after fractures, injuries, restorative and sports medicine

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Evgeniy Blum — author of the system of methods, techniques and specialized equipment Blum, professor, doctor of medical sciences, honored inventor of Russia in the field of biomechanical methods of restoring health.

The core areas of the center’s work are: rehabilitation after injuries and operations, pathologies of the musculoskeletal system in children and adults, preparation for sports competitions and injury prevention.

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Obstetric bandage for…

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Patent no. 2286823

Child rehabilitation trainer

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License LO-77-01-006109

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Book by Alexander Nikonov

Alexander Nikonov in his book “The Doctor Who Learned to Treat Everything” describes Dr. Blum’s method as effective for all conditions and diseases.

25/06

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Doctor’s article

Connective tissue dysplasia. Analysis of the professor, d.m.s. Evgeniya Bluma

Video analysis of the medical history of a 42-year-old woman. Biomechanical diagnosis: Damage to the connective tissue at the organismal level. Connective tissue dysplasia in the polymorphism of manifestations.
To understand the depth of analysis, the energy-economics of the process, the mechanisms of manifestations and the recovery technique, it is advisable to watch the video to the end.